• Title/Summary/Keyword: Methodological Quality

Search Result 416, Processing Time 0.028 seconds

Clinical Efficacy and Safety of Yukgunja-tang for Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis

  • Park, SongWon;Lim, Seong-Woo
    • The Journal of Korean Medicine
    • /
    • v.40 no.4
    • /
    • pp.16-28
    • /
    • 2019
  • Objectives: The purpose of this meta-analysis was to evaluate the effects of Yukgunja-tang(YGJT, Rikkunshito, Liujunzi) on Gastroesophageal Reflux Disease(GERD). Methods: Sixteen electronic databases were used to search for studies published through March 2019, and a randomized controlled study was conducted to study the effects of YGJT or modified YGJT on GERD. Study quality was assessed using the risk bias tool provided by Cochran, and data analysis was performed using Review Manager 5.3.0 software Results: Two-hundred and forty articles were initially searched, and 13 studies that satisfied the study criteria were evaluated qualitatively; 11 of the 13 were included in the meta-analysis. In the two studies, the effects of YGJT and a placebo were compared. Meta-analysis showed that YGJT significantly improved FSSG (Frequency Scale for the Symptoms of GERD) scores, but not GSRS (Gastrointestinal Symptom Rating Scale) scores (FSSG: MD -2.40, 95% CI [-5.31, 0.51], p=0.11, GSRS: MD 0.05, 95% CI [-0.12, 0.22], p=0.55). Meta-analysis of nine studies comparing the efficacies of YGJT and conventional medicine showed that YGJT had a significant clinical effect (OR 5.72; 95% CI [3.41, 9.61]; I2 p<0.00001). Conclusion: This study suggests that YGJT effectively relieves the symptoms of GERD. Unfortunately, owing to the small sample sizes, limitations of several methodological qualities, we believe large-scale clinical studies with less bias will provide evidence of qualitative improvement.

The Effect of Korean Herbal Medicine that Function by Inducing Diuresis for Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials (고혈압에 대한 한약 이수 처방 효과에 대한 체계적 문헌 고찰 및 메타분석)

  • Kang, Ja-yeon;Kang, Ki-wan;Jeong, Min-jeong;Kim, Hong-jun;Jan, In-soo
    • The Journal of Internal Korean Medicine
    • /
    • v.38 no.6
    • /
    • pp.902-916
    • /
    • 2017
  • Objectives: The aim of this study was to review the clinical research on antihypertensive effects of Korean herbal medicines that function by inducing diuresis. Methods: Literature searches were performed using PubMed, Cochrane, CNKI, Wanfang, Cinii, Oasis, KISS, NDSL, RISS, DBPia, with the keywords "利水", "利尿", "高血壓", "hypertension", and "lishui." The search range included only randomized controlled trials that verified the effects of Korean herbal medicine interventions on hypertension. The selected studies were assessed by risk of bias (RoB). Results: 26 reports were selected from a total of 532 identified. For these reports, meta-analysis was performed using Revman 5.3. From this analysis, it was observed that the combined treatment of Korean medicine and antihypertensive drugs had a significantly higher total effective rate (TER) and improvement in systolic blood pressure (SBP) and diastolic blood pressure (DBP) than did the use of a single antihypertensive drug. The risk ratio of TER for lowering blood pressure was 1.25. The mean differences of SBP, DBP were -19.63 mm Hg (95% confidential interval (CI), -22.45 mm Hg, -16.80 mm Hg, p<0.00001), and -5.39 mm Hg (95% CI, -7.36 mm Hg, -3.42 mm Hg, p<0.00001) respectively. The use of Korean medicine only did not improve blood pressure, as compared to the use of an antihypertensive drug. Most of items of RoB were unclear, and the methodological quality was low. Conclusions: The combination of antihypertensive drugs and Korean medical treatment can effectively improve SBP, DBP, and TER. This finding could be widely utilized in clinical practice in Korean medicine.

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Zhang, Feng-Wa;Zhou, Zhao-Yu;Wang, Hai-Lin;Zhang, Jv-Xia;Di, Bao-Shan;Huang, Wen-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.22
    • /
    • pp.9985-9996
    • /
    • 2014
  • Background and Aim: Laparoscopic and open rectum surgery for rectal cancer remains controversial. This systematic review compared the short-term and long-term efficiency and complications associated with laparoscopic and open resection for rectal cancer. Materials and Methods: We searched PubMed, Embase, Cochrane Library, ISI Web of Knowledge and the China Biology Medicine Database to identify potential randomized controlled trials from their inception to March 31, 2014 without language restriction. Additional articles were identified from searching bibliographies of retrieved articles. Two reviewers independently assessed the full-text articles according to the pre-specified inclusion and exclusion criteria as well as the methodological quality of included trials. The meta-analysis was performed using RevMan 5.2. Results: A total of 16 randomized controlled trials involving 3,045 participants (laparoscopic group, 1,804 cases; open group, 1,241 cases) were reviewed. Laparoscopic surgery was associated with significantly lower intraoperative blood loss, earlier return of bowel movement and reduced length of hospital stay as compared to open surgery, although with increased operative time. It also showed an obvious advantage for minimizing late complications of adhesion-related bowel obstruction. Importantly, there were no significant differences in other postoperative complications, oncological clearance, 3-year and 5-year or 10 year recurrence and survival rates between two procedures. Conclusions: On the basis of this meta-analysis we conclude that laparoscopic surgery has advantages of earlier postoperative recovery, less blood loss and lower rates of adhesion-related bowel obstruction. In addition, oncological outcome is comparable after laparoscopic and open resection for rectal cancer.

Passive Smoking and Cervical Cancer Risk: A Meta-analysis Based on 3,230 Cases and 2,982 Controls

  • Zeng, Xian-Tao;Xiong, Ping-An;Wang, Fen;Li, Chun-Yi;Yao, Juan;Guo, Yi
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.13 no.6
    • /
    • pp.2687-2693
    • /
    • 2012
  • Objective: Passive smoking has been considered as a risk factor of many cancers. To examine whether it might also pose a risk for cervical cancer, we performed a meta-analysis based on published case-control studies. Methods: We searched the PubMed database and references of included studies up to February 10th, 2012 for relevant studies. After two authors independently assessed the methodological quality and extracted data, a meta-analysis was conducted using CMA v2 software. Publication bias was evaluated by funnel plot, using Egger's and Begg's tests. Results: Finally 11 eligible studies yielded, involving 3,230 cases and 2,982 controls. The results showed that women who never smoke but exposed to smoking experience a 73% increase in risk of cervical cancer compared with non-exposed women (OR = 1.73, 95% CI = 1.35 - 2.21, p<0.001). Subgroup and sensitivity analyses indicated this result to be robust. Moderate publication bias was detected by visualing funnel plot, Egger's and Begg's tests. Conclusion: Based on currently available evidence, the findings of this meta-analysis suggests that passive smoking significantly and independently increases the risk of cervical cancer.

The Effects of Diabetes Management Programs using Mobile App: A Systematic Review and a Meta-Analysis (모바일 앱을 이용한 당뇨환자관리의 효과: 체계적 문헌고찰과 메타분석)

  • Kim, Hee Eon;Kim, EunJa;Kim, Gaeun
    • The Journal of the Korea Contents Association
    • /
    • v.15 no.1
    • /
    • pp.300-307
    • /
    • 2015
  • The purpose of this review was to evaluate the effects of diabetes management program using mobile appllication. A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement was conducted. Studies published between 2004 and 2014 were reviewed using the following databases: Ovid, CINAHL and Cochrane library. The keywords used were (app*OR mobile) AND (nurs* OR health* OR medic*) AND (diabet*). Selected studies were assessed for methodological quality using Scottish Intercollegiate Guidelines Network (SIGN)' Checklist. Three hundred seventy five studies were identified, All the 3 studies found mobile application as a valid strategy on clinical usefulness in diabetes management. This review provides updated evidence for app-based management program in diabetes management. Further studies are needed to increase generalizability using randomized controlled trials, enough sample size. In addition, valid measurements are needed to assess the main outcomes.

Action Research in Hospital Settings: A Literature Review of International Nursing Journals (국외 간호학술지에서의 의료기관 내 실행연구 동향분석)

  • Moon, Jeong Eun;Song, Mi-Ok;Kim, Hee Young;Park, Hyun Young;Kim, Eun A;Kim, Yun Min;Jang, Keum Seong
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.22 no.1
    • /
    • pp.46-56
    • /
    • 2016
  • Purpose: Purpose of this study was to identify major trends of action research from 2006 to 2013 and suggest directions for activating and advancing domestic action research in nursing. Methods: A review was made of 118 action research studies in hospital settings reported in international journals. Search from PubMed, Ovid, and CINHAL was done using analysis criteria developed by the researchers. General and methodological characteristics and focus on changing outcomes of action research were analyzed. Results: The major group of researchers belonged to colleges/universities (40.7%). Methods included use of qualitative methods (61.0%), research questions (24.6%), and use of theoretical models (35.6%). Prevalent data collection methods were interviews (20.2%), and 48.3% showed more than a 1-cycle process including spiral circulation structure. Focus of changing outcomes of the 56 papers including more than 1-cycle were practice (66.1%), environment (8.9%), client-nurse (7.1%). Conclusion: Trends in action research in nursing were identified providing necessary reasons to increase action research in nursing as follows: needs of various researchers including stakeholders as well as healthcare providers, various research designs including unconstrained reflection and writing, specific presentation of adapted theoretical models and action strategies, and quality assurance for validity and reliability of research processes and outcomes.

Diabetes Mellitus Reduces Prostate Cancer Risk - No Function of Age at Diagnosis or Duration of Disease

  • Xu, Hua;Mao, Shan-Hua;Ding, Guan-Xiong;Ding, Qiang;Jiang, Hao-Wen
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.1
    • /
    • pp.441-447
    • /
    • 2013
  • Background: Prior studies examining the relation between diabetes mellitus (DM) and prostate cancer risk have reported controversial findings. We examined this association by conducting a detailed meta-analysis of the peer-reviewed literature. Methods: A comprehensive search for articles of MEDLINE and EMBASE databases and bibliographies of retrieved articles published up to November, 2012 was performed. Methodological quality assessment of the trials was based on the Newcastle-Ottawa Scaleq and the meta-analysis was performed using STATA 12.0. Dose-response regression was conducted with SPSS 19.0. Results: We included 29 studies in the meta-analysis (13 case-control studies, 16 cohort studies), and found an inverse association between DM and prostate cancer (relative risk (RR) 0.84, 95% confidence interval (CI), 0.78-0.91). An inverse association was also observed in non-Asian populations (RR 0.81, 95% CI 0.76-0.87) and population-based studies (RR 0.80, 95% CI 0.77-0.91). No statistical significance was found of the association between prostate cancer risk and the duration of DM (p=0.338), and risk seemed not related with the age of DM diagnosis. Conclusions: This study suggested an inverse relationship between DM and prostate cancer, but without links to duration of disease or age of diagnosis.

Measurement Properties of Self-Report Questionnaires Measuring the Social Adjustment for Youth after Treatment of Childhood Cancer: Systematic Review (소아암 치료 종료 후 청소년의 사회적응 자가 보고 설문지의 측정 속성: 체계적 문헌고찰)

  • Oh, Su-Mi;Park, Sun-Young;Lee, Hye-Jung;Lee, Ju Hee
    • Child Health Nursing Research
    • /
    • v.24 no.1
    • /
    • pp.78-90
    • /
    • 2018
  • Purpose: The purpose of this study was to evaluate measurement properties of self-report questionnaires measuring the social adjustment for youth after treatment of childhood cancer. Methods: Social adjustment measurement tools were identified through a two-stage systematic review. First, we searched for articles using self-report questionnaires to measure the social adjustment of youth after the treatment of childhood cancer. The appropriate tools were listed and categorized. Second, using methodological filters, we searched 5 electronic databases for articles examining the measurement properties of the tools when used with youth after the treatment of childhood cancer. The quality of these papers was then evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results: Eight tools were frequently used to measure social adjustment. Eight studies investigated the measurement properties of 4 of these tools. The PedsQL 4.0 and MMQL-AF had moderate to strong evidence in some domains, but the rest of the domains had a lack of evidence. The SF-36 and KIDSCREEN-27 were validated for only a few areas. Conclusion: We found a lack of evidence regarding the measurement properties of these tools. More research is required on the measurement properties of tools for use in this population.

A Systematic Review of Studies Using Video-recording to Capture Interactions between Staff and Persons with Dementia in Long-term Care Facilities

  • Kim, Da Eun;Sagong, Hae;Kim, Eunjoo;Jang, Ah Ram;Yoon, Ju Young
    • Research in Community and Public Health Nursing
    • /
    • v.30 no.4
    • /
    • pp.400-413
    • /
    • 2019
  • Purpose: The use of video-recording offers important advantages in observing and assessing the relationship between specific behaviors in health care settings. The purpose of this systematic review is to investigate and synthesize the methodological characteristics of studies using video-technology for measuring interactions with the older persons with dementia and staff in long-term care facilities. Methods: We searched Medline, Embase and CINHAL databases for published articles in English using a video-recording method for both staff and the residents with dementia. Quantitative research design studies (e.g., descriptive or experimental studies) were included. Results: Among 5,605 searched papers, a total of 20 studies were selected for this review. Situations of video-recording were providing personal care (n=12), mealtime (n=6), and conversation (n=3). Concepts measured by video-recording were classified into two groups: 1) Staff [care practice by staff (n=13) and communication by staff (n=11)] and 2) residents [communication by resident (n=4), activities of daily life function of resident (n=8), and behavioral and psychological symptoms of dementia (n=10)]. Conclusion: This review demonstrates that video technologies are actively used to evaluate the relationship between quality of care and health outcomes of the elderly with dementia in many international nursing studies. This study provides the foundation for a future research using video-recording technologies to examine the interactions and relationships between staff and the residents in Korean long-term care settings.

The Analysis of Intervention Studies for Patients with Metabolic Syndrome (대사성증후군 중재연구 논문 분석)

  • Oh, Eui-Geum;Kim, Soo-Hyun;Hyun, Sa-Sang;Kang, Myung-Sook;Bang, So-Youn
    • Journal of Korean Academy of Nursing
    • /
    • v.37 no.1
    • /
    • pp.72-80
    • /
    • 2007
  • Purpose: This study was to analyze the trend of research on intervention for patients with metabolic syndrome. Method: Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as 'metabolic syndrome', 'intervention', 'lifestyle modification', or 'community-based' were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program - Adult Treatment Panel(NCEP-ATP III). Results: 1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent. Conclusion: Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.